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Cover Story Managing critical care supply tensions |
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KSR Publishing, Inc.
Copyright © 2012 |
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INSIDE THE CURRENT ISSUE |
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People & Opinions |
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GS1 declares: No sunset on horizon GLN, GTIN progress remains very much in progress, experts report by Rick Dana Barlow T he road to adopting and implementing supply data standards for medical/surgical products is less a race against time and waning interest and more like a convoy trudging toward bankable financial and operational efficiencies.So says a group of supply data standards advocates now simultaneously promoting GS1’s Global Location Number (GLN) and Global Trade Item Number (GTIN). The much-publicized sunrise date for the GLN happened as the stroke of midnight ushered in 2011. The GTIN sunrise date is scheduled for the close of 2012. Looking back at the GLN marketing efforts and achievements, these advocates remain bullish that interest will continue and not fade in the face of the next fashionable acronym known as the GTIN.
"The demand for GLN will continue to increase, and even accelerate," predicted Ed Miles, vice president, GS1 Healthcare US. "Current implementers continue to drive GLNs further in their systems. More and more hospitals are working with their supply chain partners to increase use. The Healthcare Transformation Group, which includes Geisinger Health System, Intermountain Healthcare, Kaiser Permanente, Mayo Clinic and Sisters of Mercy/ROi, is taking a very strong action-orientation towards accelerating GLN and GTIN implementation. These are among many recent key indicators that the demand is increasing and we anticipate that it will continue to grow." Corwin Hee, Covidien’s director, E-Business Standards, agreed with the rosy assessment because the standards might assist healthcare organizations to tackle emerging challenges. "Overall demand for GLNs will probably continue to increase as more trading partners begin to use this new identifier," Hee noted. "We will also become more sophisticated in our approach to GLNs. We may have to add new identifiers or locations in order to accommodate a number of complications like 340Bs (Public Health programs) and retail pharmacies."
"Providers see it in their interest to implement the GLN from a supply chain transparency perspective," Byer said. "The providers also understand that the GTIN is tied to a bar code, which allows bedside scanning and allows for automating the prevention of mistakes and improvements in patient safety. The FDA [Unique Device Identification] rule requiring a global standard for product identification, the future ePedigree requirements for Pharmacy and the requirements for a global ‘track and trace’ capability will cause the demand for GS1 standards to continue to increase. Also, healthcare must find a way to lower cost throughout the industry. In order to be successful in lowering cost and improving efficiencies, foundational data standards like the GLN and the GTIN must be used." With software and service suppliers working to keep pace, if not ahead of anticipated demand, providers and product suppliers will have few credible excuses to ignore adoption and implementation, according to MJ Wylie, GHX’s director of global data standardization.
Allen Esses, president, DataPros for Healthcare proffered a realistic scenario. "Like any new initiative, we will reach a tipping point in the industry once critical mass is achieved," he said. "We had our Early Adopter Group, now we see the fast followers. The appetite is there, we just need to keep moving the needle in the right direction." Meanwhile, Mayo Clinic charges forward with its end goals in sight, regardless of industry momentum, reflected Joe Dudas, director, accounting and supply chain management informatics, Division of Supply Chain Management. "We currently have $250 million in trade converted and as planned will continue conversions," Dudas noted. "We are hopeful in 2012 we can say that we are no longer accepting or maintaining proprietary account numbers." GLN lessons for GTIN? Based on what happened with the GLN campaign pre- and post-sunrise date supply data standards supporters admittedly learned a few valuable lessons. "We are spending far less time defending or promoting standards," Dudas said. "The industry seems to have taken that role. This has allowed us to focus 100 percent of our energy on conversion. GTIN is going to be harder as it is more pervasive in the supply chain."
of a major rebranding campaign. We will feature new GTINs for all of our products. We intend to work closely with our entire customer base in order to minimize confusion with our move to the new packaging. It may be much easier for customers to associate the GTIN with our packaging because of the immediate visual linkage." BD continues to support the GLN initiative even as it pushes for GTIN acceptance, according to Dennis Black, BD’s director, e-Business. "In order to maintain this support and momentum going forward, we are asking healthcare providers who are interested in transacting with GTINs to implement GLNs also," Black said. "In addition to the 2012 Sunrise Date for GTINs, the FDA’s pending UDI Regulation should help spark additional interest in GTINs."
"With the GTIN Sunrise, we are expecting that the majority of our suppliers will be providing GTINs for their products and publishing their product information to the GDSN by December 31, 2012," Byer noted matter-of-factly. "A major step forward was when MedAssets added a GDSN service contract in their portfolio in December 2010," Esses added. "It is the same solution implemented in the Early Adoption Group for healthcare. Now GPO member hospitals have one click access to a vetted purchased service contract from both a data pool and a solution provider which gives them what they need to implement GS1 standards in one data sync and services package." GDSN stands for GS1’s Global Data Synchronization Network. "We are leveraging the lessons learned from GLN and applying it to GTIN implementation initiatives," Miles reflected. "The industry is starting earlier on GTIN adoption activities, as through the GLN experience trading partners have a better understanding of any complexities involved and who to bring to the collaboration table, and see the value in moving forward now. Already, many early healthcare provider adopters have begun GTIN implementation activities, including Mayo, Geisinger, Intermountain, Kaiser, Sisters of Mercy ROi, and BJC Healthcare, to name a few. Many manufacturers, such as Abbott Vascular, Baxter, BD and J&J Medical Devices & Diagnostics Companies are providing a cross-reference of their product catalog numbers to the appropriate GTINs on their websites in advance of the 2012 GTIN Sunrise. "For years, many in the industry have been interested in the notion of having a single, unique product identification system due to its obvious connection to improved patient safety," Miles continued. "The GTIN can play a significant role in ensuring that the right product is used for patient care every step of the way, from manufacture, to delivery, to use, to the recording of that product in the patient’s electronic medical record, to billing and beyond, and the industry seems to understand that. We expect that healthcare will be working to drive adoption earlier than the sunrise date, and possibly ahead of any regulatory activity that pertains to using unique device identification to improve the collective ability to track and trace products through the supply chain. The industry appears to be rallying around the GTIN as the standard of choice for product identification, and we have seen the demand increasing." Piggybacking on GLN? Not surprisingly, many experts encourage providers and suppliers to hook their GTIN efforts on GLN accomplishments to date. "There’s built-in momentum for GLN adoption in 2011 as many GPOs are requiring clean GLN structures for their provider rosters and supplier reporting," Wylie said. "In addition, the focus on clean organizational identification reflects the need for more accurate data management throughout the healthcare supply chain." Basically, the two are complementary, according to Byer and Miles. "The GLN and the GTIN are complementary standards in the sense that the use of one requires the use of the other," Byer noted. "GLNs will be used to indicate who produced a product and where that product was shipped to, which are critical data elements for product recalls and track and trace. As we start to incorporate the use of the GTIN, a GLN will be used to identify who published that product’s information to the GDSN and a GLN will be used by a subscriber to request access to that manufacturer’s product information." Echoed Miles: "Both initiatives are complementary, build upon each other and can be implemented in parallel. It just so happened that the industry decided to focus first on GLNs as this initiative was clearly going to be led by the providers, and some felt it would be an easier process to start with and test out. From the GLN implementation experience, we now have a framework to follow in pursuing other standards implementation initiatives. The primary drivers of GTIN are the suppliers and we will focus on broad awareness and adoption activities for this segment in 2011. "For our part, GS1 Healthcare US will continue to educate, report progress and communicate the results of GLN implementation," Miles continued. "The industry members will continue to promote the use of GLNs in healthcare and work with supply chain partners not yet engaged. This should enable the industry to continue the momentum of GLN while beginning to focus on GTIN."
Because GLNs are so connected to GTINs it only makes sense to overlay adoption and implementation efforts. "The GLN educational and best practice library is robust because the community shared their successes," Esses said. "We need to do the same thing on the GTIN side with the focus on the value GTINs bring to the supply chain. Every materials manager has felt the frustration of misaligned [units of measure] so the value of the GTIN will become apparent. Once everyone sees the success of well known providers and documented return on investment, GTIN, and therefore GDSN, will gain the same momentum."
"We transitioned our GLN efforts from project to production this year," Dudas said. "It is basically business as usual and highly repetitive. That has allowed us to focus, from a project perspective, on Sunrise 2012. We are very confident that we will successfully implement early 2012 and begin the ramp up process similarly to GLN," he added. "We plan to sharpen our focus on specific business processes," Hee indicated. "One example of this is through our efforts with the GS1 US GLN workgroup. They have created a team to focus on the use of the GLN in the tracing, chargeback and rebate process. We hope to identify key obstacles and come up with solid recommendations to help improve the process through the intelligent use of the GLN." Chicken or egg? Providers and suppliers shouldn’t complicate adoption and implementation efforts by needlessly debating whether GLNs or GTINs should be tackled first to the point of indecision and inactivity, experts urged. "You could do GTIN first. We have always considered GLN as a schoolmaster and so far that has proven to be true," Dudas quipped. "You can work on both simultaneously, but the GLN is the key to unlock the GTINs residing within GDSN because it is the only way to request supplier data," Esses advised. "If the goal is GDSN, which it should be to maximize the value of the GS1 system, than it makes sense to have your GLN in progress before you take the next step." Hee asserted that users "do not need to complete your GLN work before your GTIN work. They are completely separate issues. There are challenges for each identifier that need to be addressed now. "In order to use GLNs successfully, it is extremely important to determine the business processes you wish to support," Hee continued. "That work requires personnel from across any number of internal disciplines. It will be important to ensure that those questions are answered or addressed in your GLN enumeration. "GTINs are a bit more straightforward," he said. "However, there are still important nuances that need to be considered. As an example, many systems typically assign a single quantity to an item. With the GTIN, there may be multiple GTINs representing various packaging levels for the same product. That complexity can wreak havoc unless you prepare your systems properly for a transition." Byer argued that implementing the GLN before the GTIN makes the most sense to him based on his experience. "I believe that the industry is also focused on that sequence of activities," he said. "We advise Novation members to move forward with GLN implementation today. Our feeling is that you can easily implement the GLN before GTINs are available. Many of our members want to get started, the GLN is an excellent starting point that can provide immediate value and pave the way for future success with the GTIN. I think the reality is that there will be organizations who implement both the GLN and GTIN in sequence, in a relatively close timeline to each other. I think it’s problematic to implement GTINs prior to implementing the GLN." Black politely and respectfully disagreed. "GLN is not a prerequisite for GTIN adoption," he said. "In fact, BD implemented GTINs before we started on GLNs. It is possible to implement GLNs and GTINs simultaneously. BD was a member of the Healthcare Supply Chain Standards Coalition when the Industry Sunrise Dates were originally established. HSCSC decided to create two separate Sunrise Dates to simplify the implementation process. The thought was that creating two separate Sunrise Dates would enable more effective planning and additional focus."
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